• Journal of Chest Surgery
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• v.14 no.4
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• pp.339-344
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• 1981

Eight patients underwent tracheal resection and reconstruction for tracheostomy and postintubation injuries from 1971 to early 1981. The ages ranged from 12 years to 59 years. The patients had 7-cuff stenosis and one stomal lesion in whom intubated long. Four male and four female patients were treated. Cervical approach was used in one, cervicomediastinal in 3 and transthoracic in four. The longest length of resection extended to 4 cm in whom cervico-upper half mediastinal incision and neck flexion were applied. Techniques for obtaining tension-free anastomosis included cervical flexion or division of the inferior pulmonary ligament and mobilization of the right hilum. Concurrent tracheostomy was not needed in all. There was one death at the end of emergency operation from anesthetic accident. Granulations at the anastomosis line, necessitating bronchoscopy, were noted in two and the lesion did not recurred after removal. No restenosis or other complications occurred during long follow-up.

• Proceedings of the Korean Information Science Society Conference
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• 2007.10b
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• pp.308-312
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• 2007

최근 차량용 블랙박스는 단순히 차속 및 주행 거리를 기록하는 차량 운행 기록기의 기능을 넘어, 각종 센서 및 영상 처리, GPS 장치 등을 통하여 수집된 정보를 토대로 자동차 사고 분석이나 부품 결함을 발견할 수 있는 기능을 추가 하는 것을 목표로 하고 있다. 본 논문은 자동차로부터 얻을 수 있는 정보를 다각도로 분류해 보고 자동차 사고 중 가장 놓은 비율을 차지하고 있는 차대차 사고재현을 위한 필수적인 파라미터를 선정함으로써 제한된 프로세싱 자원 하에서 사고 재현 효과를 극대화 할 수 있는 영상 블랙박스 모델을 제안하고 수집된 파라미터의 분석 절차를 제시한다.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.455-464
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• 2011

Purpose : This study is to investigate difference in the isometric muscular function of knee joints according to the time of participation in rehabilitation exercise in patients who had anterior cruciate ligament reconstruction. Methods : The subjects of this study were patients by sports injury or accident in the sports rehabilitation center of G hospital. The early exercise program group (n=7) started functional ability exercise from 2 weeks after the surgery and the late exercise program group (n=7) from 6 weeks after the surgery. Statistical analysis was used repeated measure ANOVA to test mean difference by using SPSS 18.0 for windows. Results : First, as to quadriceps femoris muscle according to the time of participation in exercise program, significant difference was observed according to interaction and time. Second, as to hamstring muscle according to the time of participation in exercise program, significant difference was observed in muscle strength according to time. Conclusion : This results suggest that if the effect of exercise program is similar between the early starting group and the late starting group, it is not necessary to have a long period of fixation as in the late exercise program group but is desirable to start functional ability exercise early in order to relieve pains in the knee joints.

• Archives of Reconstructive Microsurgery
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• v.12 no.1
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• pp.19-29
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• 2003

Soft tissue reconstruction of dorsum of the foot and ankle has long presented challenging problems for the reconstructive surgeon. Limitations of available local tissue, the need for specialized tissue, and donor site morbidity restrict the options. In an effort to solve these difficult problems, we have begun to use adipofascial flap based on the perforating branch of the peroneal artery. We present our early experience of 5 patients treated with this flap. Our patients ranged from 6 to 26 years in age and included 3 males and 2 females. The etiologies of the wounds were secondary to traffic accident, and crushing injury. The flaps had reverse flow in all patients. The flap and the adjoining raw area were covered with a full-thickness skin graft, while the donor site at the lateral aspect of the leg was closed primarily without grafting. The skin graft was taken from the inguinal area, which was closed primarily. Compared with other flap, this adipofascial flap is thinner, producing less bulkiness to the recipient site and minor aesthetic sequelae to the donor site. In our opinion, this flap is versatile, effective, and an addition to the armamentarium of the reconstructive surgeon for coverage of difficult wounds of the foot and ankle.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.51-57
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• 2004

Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

• Journal of Auto-vehicle Safety Association
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• v.5 no.1
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• pp.16-24
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• 2013

Some GM (General Motors) vehicles are using a GMLAN (General Motors Local Area Network) communication protocol for control and diagnostics. The airbag control module uses vehicle speed information from the GMLAN to record the vehicle speed as pre-crash information. In order to use the vehicle speed information for crash reconstruction purposes, it helps to be able to understand the accuracy of the data. The actual vehicle speed is not expected to be the same as the GMLAN indicated speed in some situations like a spin or if there is hard braking. This paper compares the actual vehicle speed and vehicle speed information during specific vehicle maneuvers. Actual vehicle speed is calculated from a GPS sensor, while GMLAN vehicle speed is calculated from transmission output sensor by the Engine control module (ECM). Vehicle maneuvers defined as Mode #1, Mode #2, Mode #3. The Mode #1 maneuver simulates wheel lock-up and skidding f by hard-braking at a specific speed. The Mode #2 maneuver simulates a 90degree turn using a J-turn maneuver at a specific speed. The Mode#3 maneuver simulates a 180 degree turn using a spin type of maneuver at a specific speed. The study then compares the GMLAN speed and GPS speed to see what speed difference exists between them. The results of this paper are applicable to GM vehicles only. This paper catalogs the performance and limitations of two vehicles as useful reference for crash reconstructions where there is a need to understand the speed indicated in the pre-crash section of the SDM data.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.267-269
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• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.560-564
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• 2008

Purpose: Because of traffic accidents and many criminal violences, the incidence of facial trauma has been increasing not only in adults but also in children. We planed this study to introduce our experience about pediatric blow out fracture and provide more information. Methods: We made retrospective study in 76 children with blow out fracture from January 2001 to September 2005 by retrospective chart review including detailed preoperative and postoperative evaluations, age, sex, cause, symptom and sign, and their post-operative complications. Results: Among our patients, 69 were male and 7 were female. The ages ranged from 7 to 18 years, which shows the greatest incidence of blow out fracture. Physical violence(46%) was the most common cause in this group and was followed by vehicle accident(28%), and fall down accident(17%). Left side(64%) showed slightly more incidence than right side(36%), but there were no statistical importance. Ecchymosis(88%) was the most common symptom and followed by periorbital swelling(68%) and diplopia(30%). 30 patients was diagnosed with another facial bone fracture and nasal bone(51%) was the most common associated facial bone fracture. Fourty four Patients(60%) got an orbital wall reconstruction in 7 days after trauma. After the operation, only 3 patients(4%) suffered from diplopia postoperative 3 month, and resolved in 4 years. Conclusion: The incidence of blow out fracture in children has been increasing every year, and violence has become more important etiology of pediatric blow out fracture and public and private education institutions were the most common place that blow out fracture originated. Accurate diagnosis and careful treatment plans are important in pediatric blow out fracture.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.143-148
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• 2001

The hand with amputation of all fingers is useless for activities of daily living and traumatic amputation of some of the fingers can result in the diminished ability to perform power grip and precision grip which is vital to maintain normal function of the hand. Precision grip is used to hold an object between the opposable thumb and flexed fingers. In power grip the object is held between the flexed fingers and the palm while the thumb applies the necessary counterpressure to maintain the grip on the object. A 35 year old male lost his right all fingers including thumb at the level of proximal phalanx from the pressure machinary accident. Thumb was reconstructed using wrap around flap and the second and third fingers were reconstructed using the second and third toe transplantation. Seven years after reconstruction, he uses the reconstructed thumb and the second and the third fingers for eating meals, writing down a paper with a pencil and putting on socks.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.589-594
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• 2010

Purpose: Full thickness skin grafts are useful in the reconstruction of facial skin defects when primary closure is not feasible. Although the supraclavicular area has been considered as the choice of donor site for large facial skin defect, many patients are reluctant to get a neck scar and some patients do not have enough skin to cover the defect owing to the same insult occurred to the neck such as burn accident. We present several cases of reconstruction of facial skin defects by freehand full-thickness skin graft from anterolateral chest wall resulting aesthetically acceptable outcome with lesser donor site morbidity. Methods: Retrospective review was performed from March, 2007 to September, 2009. 15 patients were treated by this method. Mean age was 31.5 years. The ethiology was congenital melanocytic nevus in 7 cases, capillary malformation in 5 cases and burn scar contracture in 3 cases. Mean area of lesion was measured to 67.3 cm2 preoperatively. The lesion was removed beneath the subcutaneous fatty tissue layer. The graft was not trimmed to be thin except defatting procedure. For the larger size of defect, two pieces of grafts were harvested from both anterolateral chest wall in separation and combined by suture. Results: The mean follow up period was 9.7 months. All the grafts survived without any problem except small necrotic areas in 4 cases, which healed spontaneously under conventional dressings in 6 weeks postoperatively. Color match was relatively excellent. There were 2 cases of hyperpigmentation immediately, but all of them disappeared in a few months. Conclusion: In cases of large facial skin defects, the anterolateral chest wall may be a good alternative choice of full-thickness skin graft.